I just came across this paper ( https://www.frontiersin.org/articles/10.3389/fnins.2020.536682/full ) which is about the complexity of astrocyte metabolism, which in turn affects brain metabolism. There are all sorts of metabolic processes going on in those cells, affecting other brain cells, so even a minor dysfunction there could result in disruptions in other brain functions. The effects can be regional, which could explain why ME varies so much. This fits into this thread, since astrocytes control the hypothalamus too.
Is your Hypothalamus up the creek?
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Inca
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Is the Hypothalamus the same thing as the Thalamus?
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I definitely think it plays a role. I had hypothalamic amenorrhea and a variety of hormonal imbalances for several years before diagnosis. I don't think its the cause per se, but I think its an important part of why I was susceptible in the first place. I've also experienced treatment-resistant depression and childhood adversity, which have been proven to cause changes in volume in the hippocampus.